Walla Walla Clinic (Professional)

LBN: Privia Medical Group Washington, Pllc
Walla Walla Clinic (Professional) is an health care organization with primary practice located at 55 W Tietan St , Walla Walla WA 99362-4445. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Privia Medical Group Washington, Pllc can be contacted via phone (509) 525-3720, or through Michelson, Kevin via phone (509) 525-3720.

Contact Information

Primary practice address
55 W Tietan St Walla Walla WA 99362-4445
Phone: (509) 525-3720
Fax: (509) 522-1592
Website:
Map and Directions
Authorized official contact:
Name: Michelson, Kevin
Phone: (509) 525-3720

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1780658419
LBN Legal business name Privia Medical Group Washington, Pllc
DBA Doing business as Walla Walla Clinic (Professional)
Authorized official Michelson, Kevin
Entity Organization
Organization subpart 1 No
Enumeration date Feb 17th, 2006
Last updated Oct 6th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780658419 NPPES
Oregon MEDICAID 208199
Oregon Other 30200
Oregon MEDICAID 7809205

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